consumer centric healthcare - v1.1
Post on 12-Apr-2017
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Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross Blue Shield Association.
Consumer Centric HealthcareChoice, Engagement, Experience
Leo BarellaBlue Cross Blue Shield of Michigan
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It’s a matter of choice….
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Google answers to anything
The Consumerism Megatrend
Implications on Healthcare
Americans Want Control
Control TV programming with TiVo
Seek employment through LinkedIn
Keep personal videos on Facebook
Maintain their music with iTunes
Buy & sell goods through eBay
Purchase stock over the internet
Bank electronically at ATMs
They don’t want limits, restrictions, waiting lines, or other barriers to their health
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The Old Paradigm: Treatment of Disease
Time
Dise
ase
Seve
rity
Reactive Medial Care
Diagnose Disease: Treat Symptoms; Costly, Trial and Error Treatment
Diagnosis
Select Drug
Switch Drug
Switch Drug Again
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How Do We Decide That a Drug “Works”
CURE
NO EFFECT
SIDE EFFECT
SERIOUS SIDE EFFECT
CURE
NO EFFECT
SIDE EFFECT
SERIOUS SIDE EFFECT
A
B
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Major Drugs Ineffective for Many
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Ineffective Therapies Can Cause Harm
Adverse Effects• Estimated 125,000 deaths per year (in 2014)
• 6th leading cause of death in the US
• Experienced by approximately 7% of patients (2.2 million) per year
• Medication-related health problems account for an estimated 3-7% of hospital admissions (Pirmohamed M, et al 2004)
• During their hospital stay, 15% of patients experienced adverse drug reactions (Davies, et al 2009)
• Increased patient non-compliance
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Personalized Medicine: Impacts Care
~ 38 types of Leukemia
~ 51 types of Lymphomas
“Disease of the Blood”
Lymphoma
Leukemia
Aggressive Lymphoma
Indolent Lymphoma
Chronic Leukemia
Acute Leukemia
Preleukemia
5 Year Survival ~0% 70%
Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, Mariotto A, Feuer EJ, Edwards BK (eds). SEER Cancer Statistics Review, 1975-2002, National Cancer Institute. Bethesda, MD, http://seer.cancer.gov/csr/1975_2002/ Based on November 2004 SEER data submission, posted to SEER web site 2005
Source: Mara G. Aspinall, former President, Genzyme Genetics
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Personalized Medicine
“Products and Services that leverage the science of genomics and proteomics (directly or indirectly) and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care.”
PricewaterhouseCoopersThe new science of personalized medicine
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Cost Per Genome
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BENCHTOP GENOME CENTER
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Effective, Efficient Health Management
Time
Dise
ase
Seve
rity
Predisposition Screening
Diagnosis/Prognosis
Right Drug Monitoring
Efficient Medial Care
Health Management; Molecular Screening, Early Detection; Rapid Effective Treatment; Improved Quality of Care
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Social Provider
Media Blog
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Social Provider
Media Blog
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$4,000
$79
KolibreeSmart toothbrush BlueAnatomy
Smart scale
TotalECG®Wireless 12 Lead ECG System
ClearProbeConnected Ultrasound Device
NICaSNon-Invasive Cardiac System
SpiroPerfectConnected Spirometer
& Pulmonary Function Test
AMDTelehealth Examination cameras
3M LittmanConnected Electronic
Stethoscope
WallDocConnected Integrated Examination Station
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Massimo Radical 7Handheld and portable pulse monitor
KinsaSmart thermometer Withings
Smart blood pressure monitor
LunaBed sensor that tracks temperature and sleep
MimoSmart baby monitors
UP3, Basis & W/MEGeneral health trackers
RejivaVital and bio snesor
CliniCloudSmart home health kit including stethoscope, thermometer and telemedicine
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It Will Largely Fall Onto the Healthcare Industry to Recognize the Value of Predictive Analytics and Implement Critical Use Cases
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Beyond Regulation, the Biggest Risk to Predictive Analytics Being Used in Healthcare is Adoption as Power Dynamics Shift
Our question: Can user experience and design influence decision making so deeply as to be regulated?
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New Data Streams, Including Those Direct From Patients, AreBeginning to be Used by Companies for Predictive AnalyticsSO MUCH DATAPercentage of venture-backed predictive analytics companies using various types of data (2011-Q3 2014)
SAM HO, M.D.Chief Medical Officer, UnitedHealthcare
“Current data sets generally revolve around claims but that’s going to be changing with lots of clinical data and transactional information with lifestyle becoming more readily accessible”
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Personalizing Care Through Predictive Analytics Represents a Significant Opportunity to Reduce Costs in the Healthcare System
$192B
OVERTREATMENT
• Eliminating care that cannot help patients – care that outmoded, supply-drive, and eschews science
• Restricting treatment and intervention to the patients who will benefit based on the individual and the context
$128B
FAILURES OF CARE DELIVERY
• Continuously studying care to identify what works for whom and in what context
• Scaling best practices including preventive care and early warning systems that demonstrate effectiveness
$35B
LACK OF CARE COORDINATION
• Ensuring those at the highest risk of costly medical episodes are
identified, monitored, and cared for between
visits and following hospitalization
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Actionable lifestyle prescription for reducing risk of disease
Greater control & patient-centered access to medical records
Treatment decisions will be improved by patient education
Greater knowledge of one’s genetic risks
Changing Role of the Consumer (Patient)
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New ethical & legal issues/quandaries
Greater reliance on HIT for decision support
Improved care through use of aggregate patient data
Highly networked, team based care
Physician as manager, rather than repository of medical knowledge
Changing Role of the Health Care Provider
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Regulatory mandates could disrupt development budgets & market plans
“Personalization” of drugs will require partnering with diagnostics companies
Uncertain economics of drug development & commercialization
New Business Strategies for Pharma
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Increased need to demonstrate cost efficiencies
Proactive strategies to limit reimbursement
Increased pressure to change paradigm towards preventive medicine
Greater emphasis on clinical validity & utility of diagnostic tests
New Demands On and From Payers
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